Oviposition behaviour of Gryon gallardoi (Hymenoptera, Scelionidae) on eggs of different ages of Spartocera dentiventris (Hemiptera, Coreidae)

The oviposition behaviour of Gryon gallardoi (Brèthes, 1914) on eggs of Spartocera dentiventris Mendonça Jr. (Berg, 1884) of different ages (2, 3, 4, 5, 6, 7, 8 and 12 days) was investigated. Groups of 12 eggs of each age were exposed to single females of G. gallardoi, and the oviposition behaviour was recorded under a stereomicroscope for two hours. Ten replicates were used for each age. In order to identify the moment the parasitoid egg was released inside the host, 1-day old eggs of S. dentiventris were exposed to G. gallardoi females, and the oviposition was interrupted at intervals of 20, 40, 60, 80, 100, 120, 140 and 160s after ovipositor insertion had initiated. Five behavioural steps were recorded: drumming, ovipositor insertion, marking, walking and resting. The average drumming and ovipositor insertion times increased with the host age (P<0.01). Ovipositor insertion usually occurred next to the longitudinal extremities of the host eggs. Marking took on average 19.5 ± 0.7s, and as walking and resting, was not affected by host age. Self-parasitism behaviour was observed in only 13.8 ± 2.3% of the eggs, being more evident with increasing patch depletion (reduction in non-parasitized eggs in the egg group, P<0.01), again with no variation due to changes in host egg age. For all ages tested, self-parasitized host eggs were less frequently contacted and accepted than non-parasitized ones (P<0.01). The parasitoid egg was released 137.0 ± 3.7s after ovipositor insertion. Spartocera dentiventris egg condition can lead to parasitoid behavioural changes, especially during the process of host choice and discrimination.

Glutathion no sangue humano normal

1.) - Woodward-Fry's and Okuda-Hess technics were employed in the determination of blood glutathione in normal healthy adults of both sexes. 2.) - It was found more accurately results with the technic of Woodward and Fry than of any others for the dosage of G. S. H. of blood. 3.) - When the process of Okuda-Hess is modified by the use of an intern indicator (starch) the readings of the end-point are much more easy and therefore the results more exacts. 4.) - The averages of the data obtained for normal blood by the technic of Woodward and Fry were for men per hundred cubic cent. 27 mgrs (G.S.H); 6.6 mgrs. (G.S.S) and 33.6 mges. (G. T) and for women: 28.4 mgrs. (G.S.H), 7.8 mgrs. (G.S.S) and 36,2 mgrs. (G.T). 5.) - Autoxidation in the blood filtrate is only apreciated after 24 hs. In the first eight hours autoxidation is never observed. 6.) - The increase of glutathione in hyperglobulia is a function of the amount of red corpuscles. In acrocyanosis arterial blood is richest in these component than venous blood and this fact is in accordance with the observation of Blanchetière, Mélon and Binet for the experimental asphyxia of dogs.

Estudo experimental de um "Schizotrypanum" do morcego "Hemiderma perspicillatum" da Venezuela

1) - Em Guarativana, Estado de Yaracuy, Venezuela, foi determinada a infecção natural de morcegos da espécie Hemiderma perspicillatum (L) por um hemoflagelado do gênero Schizotrypanum CHAGAS. 2) - As formas sanguícolas do parasito são morfologicamente muito semelhantes às do Trypanosoma phyllostomae CARTAYA, 1910, descrito em morcegos da mesma espécie, em Cuba. Sem por ora identificarmos a este parasito o que encontramos na Venezuela, continuaremos a referir-nos a este último como amostra phyllostomae (cf. DIAS, VTDJ). 3) - Os tripanosomas da amostra phyllostomae teem em média 20µ de comprimento total, possuem volumoso blefaroplasto subterminal, núcleo elíptico quese mediano, porem mais próvimo à extremidade anterior do corpo. As seguintes médias foram obtidas da medida de 100 tripanosomas: Extremidade posterior ao meio do núcleo 7,1µ; Meio do núcleo à extremidade anteior 5,0µ; Flagelo livre 7,8µ; Comprimento total 20,0µ; Posição do núcleo (índice PN/NA) 1,4. A amostra phyllostomae mostrou-se biometricamente diferençavel de todas as demais de Schizotupanum estudadas (DIAS & FREITAS). 4) - Formas de multiplicação com a morfologia de leishmania foram encontradas em coração e estômago de morcegos infectados. Tripanosomas em via de divisão nunca foram observados no sangue. 5) - Cobaia, cão e camondongo branco são sensiveis à amostra, sofrendo algumas vezes infecções intensas e mortais. Leishmanias intracelulares e lesões foram encontradas em diversos orgãos, principalmente no coração. 6) - O morcego Phyllostomae hastatus não é sensivel à amostra, apresentando apenas um parasitismo sanguíneo escasso e transitório quando inoculado e reinoculado repetidas vezes. O Molossus obscurus tambem é aparentemente insensivel, enquanto que os Molossus rufus parece receptivel ao parasito. 7) - Após numerosas passagens por animais de laboratório, a amostra Phyllostomae foi infesctante para dois exemplares de Hemiderma perspicillatum do Brasil. Os morcegos H. perpicillatum e H. perspicillatum aztecum são aparentemente resistentes á inoculação do Schizotrypanum cruzi (tipo humano). 8) - A amostra phyllostomae evoluiu facilmente em todos os artrópodes sugadores experimentados: Rhodnius prolixus, Eutriatoma nigromaculata, E. maculata, E. sordida, Panstrongylus megistus, P. geniculatus, Triatoma infestans,Psammolestes arthuri, Cimex hemipterus e Ornithodoros moubata. A evolução processa-se analogamente à do S. chuzi, terminando com a formação de tripanosomas metacíclicos no intestino posterior. 9) - Cultivos artificiais são facilmente conseguidos em meios apropriados. 10) - A amostra phyllostomae distingue-se biológica e morfologicamente de outros hemoflagelados de morcegos (amostras hastatus e vespertilionis). Biologicamente aproxima-se muito do Schizotrydanum cruzi humano, do qual é, entretanto, diferençavel por processos biométricos (DIAS, 1940, DIAS & FREITAS).

Contribuição ao estudo da Tripanosomiase Americana

1) Em trabalho sistematizado, foi estudada pela primeira vez a epidemiologia da doença de Chagas, em um trecho da região do estuário do Amazonas, cujas condições ecológicas diferem das encontradas em outras zonas onde teem sido feitas pesquisas semelhantes. 2) No local escolhido para estudo – Aura – uma localidade distante cerca de 10 km. de Belém, (Pará), não foi encontrada nenhuma infecção humana pelo S. cruzi, quer pelo exame de sangue, quer pelo xenodiagnóstico, ambos feitos em todos os habitantes (117 indivíduos). Não foi encontrada também sintomatologia atribuível à doença. 3) Em 6 xenodiagnósticos feitos em animais domésticos (5 cães e 1 gato), foi encontrado um cão infectado. Este animal pertencia á casa onde foi verificada maior infestação por Triatomídeos, com índice de infecção elevado. Pelas razões expostas no texto, porem, foi sugerida a hipótese do mesmo se ter infectado pela ingestão de vísceras de animais silvestres contaminados. 4) De 115 animais silvestres, cujo sangue foi examinado em gota espessa, 9 mostraram-se parasitados por Schizotrypanum (7,8%). Em 47 verificações pelo xenodiagnóstico, 15 animais silvestres (11 mucuras, 3 tamanduás e 1 tatú) se apresentaram positivos (32,6%) . O tamanduá (T. tetradactylus) foi pela primeira vez assinalado como depositário natural do Schizotrypanum. 5) Como resultado de buscas feitas durante 11 meses, sendo cada domicílio inspecionado pelo menos de 15 em 15 dias, foram encontrados Triatomídeos em 7 das 36 casas existentes no povoado. Todos os 39 exemplares capturados eram adultos; a procura exaustiva não revelou a existência de formas jovens no interior das habitações. Na ordem de freqüência, as espécies encontradas foram as seguintes: P. geniculatus (29 exemplares, dos quais 7 infectados); R. pictipes ( 9 exemplares, dos quais 2 infectados); E. mucronatus ( 1 exemplar, não infectado) . A grande maioria dos insetos foi capturada na segunda metade do ano (época do estío). 6) Em plena mata, n’uma toca de tamanduá (T. tetradactylus) foram encontradas larvas, ninfas e adultos de P. geniculatus. A casa situada mais próximo desse foco, foi a que apresentou maior infestação (22 exemplares) e exclusiva para essa espécie. Em uma toca de macaco da noite (P. flavus), foi encontrada uma larva de Triatomídeo. Este foco também ficava próximo à casa acima referida. Em toca de P. flavus foi também achado um exemplar adulto de Panstrongylus refotuberculatus. 7) Amostras de S. cruzi isoladas de animais silvestres, mostraram fraco poder infectante. A amostra isolada do cão, embora infectando facilmente os animais de laboratório, pelos estudos biométricos feito por DIAS e FREITAS, afasta-se das amostras humanas típicas. 8) São discutidos os resultados acima referidos e, pelos hábitos dos transmissores, pela predominância de depositários silvestres do parasito, conclue-se pela natureza silvestre da Tripanosomiase Americana no local estudado. Se bem que não tenham sido verificadas infecções humanas, dado o encontro de um cão parasitado – infecção esta que se pode ter verificado pelo meio normal da transmissão da moléstia – admite-se a possibilidade do aparecimento de casos humanos nessa região. Ressalta-se a confirmação que tais resultados parecem trazer á hipótese de CARLOS CHAGAS, que pensava ser esta doença primitivamente silvestre, com posterior adaptação aos animais domésticos e ao homem.

Carcinoma metastatico do baço

Among the material of the archives of the Pathological Section of the Oswaldo Cruz Institue (Rio de Janeiro, Brasil) we found 9 cases of cancer metastasis in the spleen. Four of them were macroscopically apparent, but five had only been diagnosed microscopically. Of these cases of tumors, 3 are adenocarcinoma originated from the pancreas (cases 1, 3, 5,); 3 are primary carcinoma of stomach (cases 7,8 and 9); 1 adenocarcinoma of gall-bladder (case 2); 1 originated form the mammary gland (case 4) and finally 1 form the colon. (case 6.). The incidence of the metastasis observed in the spleen among the total of 6.400 studied autopsies is of 0,14%; The same incidence among those of epithelial blastomata is of 1,8%.

Sôbre a hiperplasia celular no mixoma infectuoso do coelho

Definite hyperplasia of cells occurs in the skin lesions of the infectious myxoma of rabbits, more visible in such stages in which the intercellular basophilic substance is rather scanty (fig. 2). The increase in number of cells is the result of simplified forms of mitosis (modified type of mitosis, pseudoamitosis) which might readily be mistaken for amitosis in their final stages. Budding (figs. 20, 28, 29, 30) as well as constriction of the nucleus (figs. 18, 31, 32), and the formation of giant-cells (figs. 33, 34) are not rare. During the entire process the nuclear membrane does not desintegrate as in typical mitosis. Division of the cytoplasm following division of the nucleus has been demonstrated (fig. 17). Typical mitosis is practically absent. The cells which undergo hyperplasia present remarkable changes in their dimension, shape, and structure. The nucleus and cell-body are considerably enlarged (figs. 6, 7, 8). The shape of the nucleus is modified (figs. 8, 10, 15). Hypertrophy of nuclein, either as an intranuclear network (spireme?, figs. 9, 23), or in the form conspicuous, deeply staining masses which appear not to be homogeneous but to be composed of small particles closely clumped ("mulberries"?, figs. 12, 13, 14, 25, 26) occurs in most cells. While some of these pictures are probably related to necrosis of the cells as started by most of the previous workers, it is lekely that some of them may represent developmental stages of the modified mitosis (pseudoamitosis) here reported. In fact, fine cytological details not ordinarily preserved in necrotic cells (figs. 35, 36, 37) may be demonstrated in the socalled myxoma-cells subtted to approved cytological methods of study (fixation in B-15 and P. F. A.-3, staining in iron-hematoxylin).

Estudos sôbre o pneumococo: 4a. nota - Influência do pH do meio sôbre a formação da cápsula pelo pneumococo

One of the features of pneumococcus which has deserved the attention of investigators is the capsule. Since Pasteur, Chamberland and Roux (1881) several functions have been ascribed to it as well as peculiar properties. In the present paper, we take into consideration one only aspect of this problem; it is the relationship which there possibly may be between acidity of the culture medium and the power of capsule formation by pneumococcus. As it is known, this germ requires for its development 7.8 as an optimum pH, but maintains its biological activities down to 5.6. These variations do not take place without large alterations, particularly of the capsule, not only from the morphological but also from the chemical viewpoint. The diameter of the mucous envelopment of the pneumococcus decreases in proportion to the increase of acidity down to its complete extinction. This fact has been regarded by investigators as a biological feature inhe¬ring to the germ itself and as proceeding of self-defense. In an acid medium the existing capsule is destroyed and the germ does not produce it again; consequently, acidity inhibits the formation of the capsule. We tried to check how this phenomenon comes to pass and to elucidated it. As we know, the fundamental compound of the pneumococcus capsule is mucin. In the first place, we experimented the action of acidity on same in the following manner: Mucin extracted from bovine submaxillary gland is precipitated by HC1 at a determined concentration degree; the mucin dissolves again and precipi¬tates in function of this concentration. This property of mucin (solubility in acid medium) modifies a little the interpretation of the mechanism of disappearance of the capsule from the said germ in the culture medium. Indeed: The acidification of the medium consecutive to the growth of pneumococcus reduces the dimensions of the capsule until causing its com¬plete disappearance; but on transferring this strain to new optimum cultiva¬ting conditions the capsule appears again exhuberantly, at times as anteriorly, although with biased virulence. Linking these two facts we draw the following conclusions: Pneumo¬coccus does not lose its capacity of capsule formation in an acid medium; but mucin, whilst being produced, is entirely dissolved in this medium by the aid of acidity; we venture to state that, in spite of medium acidity, the capacity of capsule production is a constant feature of pneumococcus and that the disappearance of the capsule does not depend on the pneumococcus in itself when it produces smooth colonies, but on the chemical properties of mucin, mainly on its solubility in acid medium.

Estudos aplicados à recuperação biológica da Baía de Guanabara

Continuamos observações sobre as biocenoses litorâneas, na parte oeste do Rio de Janeiro, na Enseada mais poluída, onde está a ilha do Pinheiro. Chegamos à conclusão que há graus de estragos acima dos verificados em publicações anteriores, os 7º, 8º, 9º e 10º graus de estragos, com desaparecimento de todas cinturas vegetais. Anotamos os assoreamentos; devido a aterros artificiais na vizinhança, a lama subiu muito, meio metro em 20 anos, ou seja 2,5 centímetros por ano. Apresentamos as alterações ecológicas resultantes do assoreamento, mostramos a mudança de vários nichos de alguns componentes do manguezal. Fizemos 4 mapas ecológicos, em local que constitui a média representativa do que se passou na Enseada de Inhaúma nesses últimos 5 anos. Chegamos a índices de recuperação de zonações do manguezal, como 60/1 para o Avicennietum; e nenhum para o Laguncularietum, comunidade de "mangues mansos" que está em regressão; Houve regeneração das populações de caranguejos Ucides e Cardisoma que voltaram a habitar a Ilha do Pinheiro. Mostramos uma correlação entre o guaiamu e a aroeira da praia, Schinus. Concluímos que: podem ser usadas as técnicas de recuperação de poluição para esses caranguejos e guaiamus, para a alimentação humana, assim como para peixes apanhados em alagados de manguezais poluídos. O material pescado no Rio de Janeiro, tendo algas do gênero Oscillatoria, apresenta um cheiro de urina pútrida, bem como outros cheiros, mas pode ser recuperado para a alimentação humana. Damos sugestões para se utilizar cercados de vegetação de manguezal contra a poluição em locais apropriados, alagados com camarões e peixes, como usam-se na Ásia. As plantas utilizadas baseiam-se no estudo ecológico que estabelece o nicho apropriado a cada uma delas, resistente á poluição, e que pode combater alguns estragos; entre elas as Iresine e as do gênero Avicennia, pois elas promoveram uma pequena recuperação na Ilha do Pinheiro, onde apareceram novamente os caranguejos e guaiamus.

Blood parasites of some birds from São Paulo State, Brazil

A total of 3.449 birds, representing 195 species of 33 families from three areas in São Paulo State, Brazil, were examined for hematozoa during the period 1967-1972. Only 268 birds (7.8%) of 21 families harbored a blood parasite, which represented by species of Haemoproteus (3.5%), microfilaria (2.6%), Plasmodium (1.8%), Trypanosoma (0.8%) and Leucocytozoon (0.06%). The prevalence was similar in each of the six years of the study but a marked decrease in prevalence was noted in February and June of each year. The prevalence of parasitism was significantly different in each of the three areas sampled.

Comportamento de Biomphalaria glabrata (Say, 1818) como critério de toxicidade em ensaios biológicos com moluscicidas

Visando à aplicação sistemática de parâmetros comportamentais como indicadores da ação tóxica de moluscicidas empregados no combate aos hospedeiros intermediários do Schistosoma mansoni, um procedimento para avaliação quantitativa do efeito de dose sobre o comprotamento de Biomphalaria glabrata foi desenvolvido, com base no paradigma recomendado pela O.M.S. para ensaios biológicos e envolvendo registro comportamental por cenematografia ocm lapso de tempo: caramujos com 5 7/8 ± 1/8 giros eram subemtidos a diferentes concentrações subletais de sulfato de cobre durante 24 horas e em seguida transferidos para recuperação em água destilada desionizada; a partir da análise dos registros foram computados (a) a freqüência total de subidas à superfície por indivíduo, (b) a frqüência total de saídas da água por indivíduo e (c) a proporção média de indivíduos no terço superior do recipiente de teste. O método Litchfield-Wilcoxon foi empregaod para determinação de índices de referência (denominados "concentrações de efieto comportamental de 50%" ou CEC50) em relação a cada parâmetro, e os valores obtidos - (a) 0,010, (b) 0,006 e (c) 0,029 ppm de cobre - não só evidenciaram a exeqüibilidade da aplicação sistemática de critérios comportamentais de toxidade, como se revelaram capazes de detectar o efieto tóxico do produto em concentrações muito infereiores às obtidas nas determinações convencionais de letalidade. Os dados também mostraram alterações na atividade dos caramujos em decorrência do ciclo de iluminação dia-noite. Embora o esclarecimento dos aspectos etológicos envolvidos no problema do controle químico do vetor dependa da análise das relações entre o indivíduo e seu ambiente natural, estudos de laboratório com mensurações acuradas de parâmetros relacionados a comportamentos de proteção podem fornecer subsídios relevantes a respeito.

Photodynamic therapy with mTHPC and polyethylene glycol-derived mTHPC: a comparative study on human tumour xenografts.

The photosensitizing properties of m-tetrahydroxyphenylchlorin (mTHPC) and polyethylene glycol-derivatized mTHPC (pegylated mTHPC) were compared in nude mice bearing human malignant mesothelioma, squamous cell carcinoma and adenocarcinoma xenografts. Laser light (20 J/cm2) at 652 nm was delivered to the tumour (surface irradiance) and to an equal-sized area of the hind leg of the animals after i.p. administration of 0.1 mg/kg body weight mTHPC and an equimolar dose of pegylated mTHPC, respectively. The extent of tumour necrosis and normal tissue injury was assessed by histology. Both mTHPC and pegylated mTHPC catalyse photosensitized necrosis in mesothelioma xenografts at drug-light intervals of 1-4 days. The onset of action of pegylated mTHPC seemed slower but significantly exceeds that of mTHPC by days 3 and 4 with the greatest difference being noted at day 4. Pegylated mTHPC also induced significantly larger photonecrosis than mTHPC in squamous cell xenografts but not in adenocarcinoma at day 4, where mTHPC showed greatest activity. The degree of necrosis induced by pegylated mTHPC was the same for all three xenografts. mTHPC led to necrosis of skin and underlying muscle at a drug-light interval of 1 day but minor histological changes only at drug-light intervals from 2-4 days. In contrast, pegylated mTHPC did not result in histologically detectable changes in normal tissues under the same treatment conditions at any drug-light interval assessed. In this study, pegylated mTHPC had advantages as a photosensitizer compared to mTHPC. Tissue concentrations of mTHPC and pegylated mTHPC were measured by high-performance liquid chromatography in non-irradiated animals 4 days after administration. There was no significant difference in tumour uptake between the two sensitizers in mesothelioma, adenocarcinoma and squamous cell carcinoma xenografts. Tissue concentration measurements were of limited use for predicting photosensitization in this model.

A review of achievements of the national schistosomiasis control program in middle and upper Egypt areas

In Egypt the "national schistosomiasis control program" was formulated to control transmission by reduction of prevalence and intensity of current infections, and thereby achieve an acceptable level of schistosomiasis disease control. The program was implemented foremost in Middle Egypt (1977) and Upper Egypt (1980), collectively extending 800 km alongside of the River Nile and accommodate about 10.5 million people. Schistosoma haematobium has been essentially the prevailing species infection in both areas. The strategy of control entailed both area-wide mollusciciding with niclosamide, and selective population chemotherapy with metrifonate. Evaluation in 1986 showed that prevalence dropped from pre-control 29.4% in Middle Egypt and 26.3% in Upper Egypt to 6% and 7.8% respectively, together with a remarkable drop of infections among children. Also mean intensity attained low levels consistent of low grade infections. It is evident therefore that in these areas where an enhancement of schistosomiasis infections had been anticipated the employment of the twofold strategy effected a state of low-prevalence/low-intensity signifying a lowered reservoir of infection and a substantial interference with the potentials of transmission.

Bioquímica da esquistossomose mansônica: VII. Alterações lipídicas das membranas lisossômicas durante a faze inicial da agressão hepática

Com o intuito de se estudarem as alterações nos teores lipídicos, constituintes das membranas lisossômicas, em fígados, durante a fase inicial da agressão esquistossomótica, foram utilizados camundongos infectados com 30 cercárias e 30 dias de infecção. Os triaglicerídios passaram de 200 ± 48 µg/mg de proteínas totais nos controles, para 165 ± 22 µg/mg, nos infectados. Na mesma ordem também diminuiram o colesterol livre de 539 ± 80, para 396 ± 54 µg/mg; os ésteres do colesterol de 270 ± 35, para 216 ± 36 µg/mg e os colinafosfatídios de 44 ± 5,7 para 31 ± 4,9 µg/mg. Os serinafosfatídios, os etanolaminafosfatídios e os esfingofosfatídios aumentaram, respectivamente de 58 ± 9,7 para 60 ± 8,5, de 72 ± 7,8 para 111 ± 15,7 e de 36 ± 4,9 para 63 7,1 µg/mg. Os ácidos graxos livres não se alteram significativamente, passaram de 1,7 ± 0,35 µEq/g, nos controles, para 1,8 ± 0,29 Eq/g nos animais infectados. Esses resultados padecem indicar que na fase inicial de esquistossomose mansônica hepática, antes da formação dos granulomas, são detectadas alterações importantes na constituição lipídica das membranas do compartimento lisossônico. Elas, talvez, sejam devidas a produtos catabólicos, excretados por vermes imaturos ou adultos, presentes em vasos do sistema portal.

Elevated blood pressure prevalence in children did not follow the increase in overweight: results from a school-based study in a rapidly developing country, 1998-2006

Background: Blood pressure (BP) is strongly associated with body weight and there is concern that the pediatric overweight epidemic could lead to an increase in children's mean BP. Objectives: We analyzed BP trends from 1998 to 2006 among children of the Seychelles, a rapidly developing middle-income country in Africa. Methods: Serial school-based surveys of weight, height and BP were conducted yearly between 1998-2006 among all students of the country in four school grades (kindergarten, 4th, 7th and 10th years of compulsory school). We used the CDC criteria to define "overweight" (BMI _95th sex-, and age-specific percentile) and the NHBPEP criteria for "elevated BP" (BP _95th sex-, age-, and height specific percentile). Methods for height, weight, and BP measurements were identical over the study period. The trends in mean BMI and mean systolic/diastolic BP were assessed with linear regression. Results: 27,703 children aged 4-18 years (participation rate: 79%) contributed 43,927 observations on weight, height, and BP. The prevalence of overweight increased from 5.1% in 1998-2000 to 8.1% in 2004-2006 among boys, and from 6.1% to 9.1% among girls, respectively. The prevalence of elevated BP was 8.4% in 1998-2000 and 6.9% in 2004-2006 among boys; 9.8% and 7.8% among girls, respectively. Over the 9-years study period, age-adjusted body mass index (BMI) increased by 0.078 kg/m2/year in boys and by 0.083 kg/m2/year in girls (both sexes, P_0.001). Age- and height-adjusted systolic BP decreased by -0.37 mmHg/year in boys and by -0.34 mmHg/year in girls (both sexes, P_0.001). Diastolic BP did not change in boys (-0.02 mmHg/year, P: 0.40) and slightly increased in girls (0.07 mmHg/year, P: 0.003). These trend estimates were altered modestly upon further adjustment for BMI or if analyses were based on median rather than mean values. Conclusion: Although body weight increased markedly between 1998 and 2006 in this population, systolic BP decreased and diastolic BP changed only marginally. This suggests that population increases in body weight are not necessarily associated with corresponding rises in BP in children.

Establishing an association between a peri-operative perfusion score system (PerfSCORE) and post-operative patient morbidity/mortality during CPB cardiac surgery.

BACKGROUND: To date, there is no quality assurance program that correlates patient outcome to perfusion service provided during cardiopulmonary bypass (CPB). A score was devised, incorporating objective parameters that would reflect the likelihood to influence patient outcome. The purpose was to create a new method for evaluating the quality of care the perfusionist provides during CPB procedures and to deduce whether it predicts patient morbidity and mortality. METHODS: We analysed 295 consecutive elective patients. We chose 10 parameters: fluid balance, blood transfused, Hct, ACT, PaO2, PaCO2, pH, BE, potassium and CPB time. Distribution analysis was performed using the Shapiro-Wilcoxon test. This made up the PerfSCORE and we tried to find a correlation to mortality rate, patient stay in the ICU and length of mechanical ventilation. Univariate analysis (UA) using linear regression was established for each parameter. Statistical significance was established when p < 0.05. Multivariate analysis (MA) was performed with the same parameters. RESULTS: The mean age was 63.8 +/- 12.6 years with 70% males. There were 180 CABG, 88 valves, and 27 combined CABG/valve procedures. The PerfSCORE of 6.6 +/- 2.4 (0-20), mortality of 2.7% (8/295), CPB time 100 +/- 41 min (19-313), ICU stay 52 +/- 62 hrs (7-564) and mechanical ventilation of 10.5 +/- 14.8 hrs (0-564) was calculated. CPB time, fluid balance, PaO2, PerfSCORE and blood transfused were significantly correlated to mortality (UA, p < 0.05). Also, CPB time, blood transfused and PaO2 were parameters predicting mortality (MA, p < 0.01). Only pH was significantly correlated for predicting ICU stay (UA). Ultrafiltration (UF) and CPB time were significantly correlated (UA, p < 0.01) while UF (p < 0.05) was the only parameter predicting mechanical ventilation duration (MA). CONCLUSIONS: CPB time, blood transfused and PaO2 are independent risk factors of mortality. Fluid balance, blood transfusion, PaO2, PerfSCORE and CPB time are independent parameters for predicting morbidity. PerfSCORE is a quality of perfusion measure that objectively quantifies perfusion performance.